Have you ever stood up too fast and had your head spin for a second? Or gotten off a ride at an amusement park or fair that went round and round? Dizziness can be momentarily fun, but if you get dizzy a lot, it can be rather disconcerting.
Dizziness is a common phrase people will say when they get the feeling of vertigo or some other “off” feeling. However, dizziness may mean different things to different people. In physical therapy we can treat different disorders that involve dizziness but the cause of the actual dizziness may be different.
A person may feel dizzy when experiencing a “bad signal” between any of the three balance systems to the brain. The main systems that help balance are eyes, inner ear, and joints (or proprioception). Each of these systems communicates to different parts of the brain, to help paint a picture of what the body is doing. A good example of a bad connection between your
brain and balance systems is motion sickness. The eyes are seeing movement past objects or rocking up and down on the waves; but the inner ear is not sending signals to the brain that there is indeed movement. The mismatch of signals results in nausea.
There different types of dizziness a person can experience.
Vertigo is the sensation of movement, when one is not moving. It is often described as a spinning, or tilting. This may occur for a few seconds or minutes. Other odd sensations that may be experienced with vestibular or cervical dysfunction is disequilibrium.
Disequilibrium is more characteristic of feeling unsteady whenever one is moving. This feeling should dissipate with sitting or lying down.
Syncope, or the feeling experienced prior to fainting, is another sensation people may relate to dizziness. This can be a symptom of a more serious issue and may require further testing by your medical team.
The role of the PT with treating dizziness is to try to investigate what is truly causing the dizziness.
Dizziness can be caused by an inner ear disorder, such as BPPV (Benign Paroxysmal Positional Vertigo), a vestibular nerve irritation, or damage to the inner ear organ, or labyrinth.
A neck joint issue can also give the sensation of feeling dizzy. Whiplash in juries or neck strains can affect the signals that help to tell the brain where the head is in space, which can result in the feeling of dizziness.
Once the physical therapist has identified the cause of dizziness, a treatment plan will be tailored to help treat that problem. This may include vestibular desensitization exercises, manual
therapy, balance training, eye movement therapy, and strengthening exercises as a part of the plan of care. All of these elements will help to treat not only dizziness, but also any subsequent
compensation developed, and help to reduce risk for re-injury.
